Andrea P Salgado1, Negar Ashouri2, Erika K Berry1, Xiaoying Sun3, Sonia Jain3, Jane C Burns4, Adriana H Tremoulet5. 1. Pontificia Universidad Catolica de Chile, Santiago, Chile. 2. Children's Hospital, Orange County, CA. 3. Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA. 4. Department of Pediatrics, University of California, San Diego, California/Rady Children's Hospital San Diego, La Jolla, San Diego, CA. 5. Department of Pediatrics, University of California, San Diego, California/Rady Children's Hospital San Diego, La Jolla, San Diego, CA. Electronic address: atremoulet@ucsd.edu.
Abstract
OBJECTIVES: To characterize the clinical presentation and outcome in infants <6 months of age with Kawasaki disease (KD) and to describe the use of newer anti-inflammatory therapies in this young population. STUDY DESIGN: We evaluated 88 infants?<6 months old and 632??6 months old treated for KD. We compared differences in laboratory data, response to treatment, and coronary artery outcomes between the 2 cohorts. Fisher exact test was used to analyze categorical variables, whereas the Wilcoxon rank sum test was used for continuous variables. RESULTS: The majority of children in both cohorts were diagnosed and treated within the first 10 days of illness (median illness day 6 in both cohorts). For patients treated within the first 10 days after fever onset, a larger proportion of infants <6 months old had a dilated or aneurysmal coronary artery on the initial echocardiogram compared with those ?6 months old (43.4% vs 19.5%). Furthermore, 18.6% of infants?<6 months old who had a normal echocardiogram at diagnosis, developed a dilated or aneurysmal coronary artery on a subsequent echocardiogram within 8 weeks of diagnosis. Twenty-eight infants?<6 months old received a single dose of infliximab without any untoward effects. CONCLUSIONS: Despite treatment in the first 10 days, infants?<6 months old with acute KD are more likely to develop coronary artery abnormalities. Thus, the development of adjunctive therapies to reduce coronary artery damage should target this population.
OBJECTIVES: To characterize the clinical presentation and outcome in infants <6 months of age with Kawasaki disease (KD) and to describe the use of newer anti-inflammatory therapies in this young population. STUDY DESIGN: We evaluated 88 infants?<6 months old and 632??6 months old treated for KD. We compared differences in laboratory data, response to treatment, and coronary artery outcomes between the 2 cohorts. Fisher exact test was used to analyze categorical variables, whereas the Wilcoxon rank sum test was used for continuous variables. RESULTS: The majority of children in both cohorts were diagnosed and treated within the first 10 days of illness (median illness day 6 in both cohorts). For patients treated within the first 10 days after fever onset, a larger proportion of infants <6 months old had a dilated or aneurysmal coronary artery on the initial echocardiogram compared with those ?6 months old (43.4% vs 19.5%). Furthermore, 18.6% of infants?<6 months old who had a normal echocardiogram at diagnosis, developed a dilated or aneurysmal coronary artery on a subsequent echocardiogram within 8 weeks of diagnosis. Twenty-eight infants?<6 months old received a single dose of infliximab without any untoward effects. CONCLUSIONS: Despite treatment in the first 10 days, infants?<6 months old with acute KD are more likely to develop coronary artery abnormalities. Thus, the development of adjunctive therapies to reduce coronary artery damage should target this population.
Authors: L LuAnn Minich; Lynn A Sleeper; Andrew M Atz; Brian W McCrindle; Minmin Lu; Steven D Colan; Beth F Printz; Gloria L Klein; Robert P Sundel; Masato Takahashi; Jennifer S Li; Victoria L Vetter; Jane W Newburger Journal: Pediatrics Date: 2007-11-19 Impact factor: 7.124
Authors: Adriana H Tremoulet; Sonia Jain; Pei-Ni Jone; Brookie M Best; Elizabeth H Duxbury; Alessandra Franco; Beth Printz; Samuel R Dominguez; Heather Heizer; Marsha S Anderson; Mary P Glodé; Feng He; Robert L Padilla; Chisato Shimizu; Emelia Bainto; Joan Pancheri; Harvey J Cohen; John C Whitin; Jane C Burns Journal: J Pediatr Date: 2019-09-24 Impact factor: 4.406
Authors: Sarah D de Ferranti; Kimberlee Gauvreau; Kevin G Friedman; Alexander Tang; Annette L Baker; David R Fulton; Adriana H Tremoulet; Jane C Burns; Jane W Newburger Journal: JAMA Pediatr Date: 2018-12-03 Impact factor: 16.193